<!DOCTYPE html>
<html lang="zh">
<head>
    <meta charset="utf-8">
    <title>基本信息--Layui</title>
    <meta name="renderer" content="webkit">
    <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
    <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1">
    <meta name="apple-mobile-web-app-status-bar-style" content="black">
    <meta name="apple-mobile-web-app-capable" content="yes">
    <meta name="format-detection" content="telephone=no">
    <link rel="stylesheet" href="../../layui/css/layui.css" media="all"/>
    <link rel="stylesheet" href="../../css/public.css" media="all"/>
</head>
<body class="childrenBody">
<form class="layui-form layui-row layui-col-space10">
    <div class="layui-col-md12 layui-col-xs12">
        <div class="layui-row layui-col-space10">
            <div class="layui-col-xs3">
                <div class="layui-form-item magt3">
                    <label class="layui-form-label">患者姓名：</label>
                    <div class="layui-input-block">
                        <input type="text" class="layui-input name" lay-verify="name" name="name" disabled
                               placeholder="未填写">
                    </div>
                </div>
            </div>
            <div class="layui-col-xs3">
                <div class="layui-form-item magt3">
                    <label class="layui-form-label">患者性别：</label>
                    <div class="layui-input-block">
                        <input type="text" class="layui-input gender" lay-verify="gender" name="gender" disabled
                               placeholder="未填写">
                    </div>
                </div>
            </div>
            <div class="layui-col-xs3">
                <div class="layui-form-item magt3">
                    <label class="layui-form-label">患者年龄：</label>
                    <div class="layui-input-block">
                        <input type="text" class="layui-input age" lay-verify="age" name="age" disabled
                               placeholder="未填写">
                    </div>
                </div>
            </div>
            <div class="layui-col-xs3">
                <div class="layui-form-item magt3">
                    <label class="layui-form-label">手机号码：</label>
                    <div class="layui-input-block">
                        <input type="text" class="layui-input phone" lay-verify="phone" name="phone" disabled
                               placeholder="未填写">
                    </div>
                </div>
            </div>
            <div class="layui-col-xs12">
                <div class="layui-form-item magt3">
                    <label class="layui-form-label">慢性病史：</label>
                    <div class="layui-input-block">
                        <input type="text" class="layui-input pastMedicalHistory" lay-verify="pastMedicalHistory" name="pastMedicalHistory" disabled
                               placeholder="未填写">
                    </div>
                </div>
            </div>
            <div class="layui-col-xs12">
                <div class="layui-form-item magt3">
                    <label class="layui-form-label">过敏病史：</label>
                    <div class="layui-input-block">
                        <input type="text" class="layui-input historyDrugAllergy" lay-verify="historyDrugAllergy" name="historyDrugAllergy" disabled
                               placeholder="未填写">
                    </div>
                </div>
            </div>
            <div class="layui-col-xs6">
                <div class="layui-form-item magt3">
                    <label class="layui-form-label">患者标签：</label>
                    <div class="layui-input-block">
                        <input type="text" class="layui-input bq" lay-verify="bq" name="bq" disabled
                               placeholder="未填写">
                    </div>
                </div>
            </div>
            <div class="layui-form-item magb0">
                <hr class="layui-bg-gray"/>
            </div>
        </div>
<!--        <div class="layui-form-item magb0">-->
<!--            <hr class="layui-bg-gray"/>-->
<!--            <div class="layui-center">-->
<!--                <a class="layui-btn layui-btn-normal" style="width: 130px" lay-filter="submit" lay-submit>保存</a>-->
<!--            </div>-->
<!--        </div>-->
    </div>
</form>
<script type="text/javascript" src="../../js/jquery-1.11.2.min.js"></script>
<script type="text/javascript" src="../../js/jquery.cookie.js"></script>
<script type="text/javascript" src="../../layui/layui.js"></script>
<script type="text/javascript" src="../../js/constants.js"></script>
<script type="text/javascript" src="tool03Info.js"></script>
</body>
</html>